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The south-facing entry elevation is protected by metal-mesh panels that help define a shaded zone with covered outdoor spaces on the ground level.


Seattle Children's Bellevue Clinic

Bellevue, Seattle

Health Care Goes Lean and Green: By emphasizing efficiency in construction, design, and performance, a regional clinic for a major children's hospital pursues a sustainable agenda.

By Clifford A. Pearson
March 2012

With their large footprints, energy-intensive equipment, and hermetically sealed indoor spaces, hospitals and health-care facilities are notoriously resistant to green design. So the architects, general contractor, and consultants working on a new outpatient clinic and surgery center for Seattle Children's Hospital faced a big challenge. "Health care has been one of the slowest markets to adopt sustainability," states Yancy Wright, sustainability director for Sellen, the contractor for Seattle Children's Bellevue Clinic (SCBC). But the client wanted SCBC, its first new facility outside its base in Seattle, to serve as a prototype for other clinics and knew it needed to approach the project in a fresh way. Although green design was not a high priority for the client at the start, it became increasingly important during the design and construction process. By the time the building opened in June 2010, it had earned LEED-Gold certification and Seattle Children's had committed itself to the 2030 Challenge of creating carbon-neutral facilities.


Location Bellevue, Washington (Lake Washington watershed)

Gross area 186,000 ft2 including two levels of parking (17,280 m2)

Completed June 2010

Cost $40 million

Annual purchased energy use (based on utility bills) 162.7 kBtu/ft2 (1847.2 MJ/m2), 27% reduction from base case. Note: Energy use includes lighting and fans for 107,000 ft2 parking garage

Annual carbon footprint 32.2 lbs. CO2/ft2 (157.5 kg CO2/m2)


Structural systems Nucor Steel

Exterior cladding Architectural Precast Structures, precast concrete panels

Wood Edensaw Woods

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Seattle Children's Bellevue Clinic
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From the beginning, Seattle Children's emphasized efficiency, in terms of both processes and final product. It asked Sellen and the architect, NBBJ, to use integrated project delivery (IPD), working as a team and assuming certain risks and rewards based on the building's being completed on time and budget. (Sellen and NBBJ each staked 1 percent of the construction cost, which they would lose if the project didn't meet budget and scheduling goals, and they would win if it did. They ended up with 95 percent of the reward.)

The focus on efficiency reinforced the designers' arguments for sustainable strategies. For example, instead of accepting standard sizes and layouts for surgical suites, recovery rooms, and laboratory areas, the client and the design/construction team built full-scale mock-ups of these spaces to test new approaches. The process led the team to group related facilities together—such as placing induction rooms (where anesthesia is administered) right next to operating rooms—and designing spaces that could be used for more than one purpose. As a result, NBBJ and Sellen were able to cut 30,000 square feet from the building's size and save $30 million. And by involving 50 of SCBC's staff in testing out the mock-ups, they got doctors and nurses to buy into the changes instead of resisting them.

Just as important, the new spatial arrangements and functional adjacencies created a better work environment for staff and a more pleasant experience for patients and their families, says Paula Holmes, Senior Director, Regional Operations and Service Lines for Seattle Children's. Placing induction rooms next to operating rooms, for example, establishes a more efficient flow for medical personnel and allows them to perform more surgeries. It also allows family members to stay with their child until right before surgery, reducing anxiety for both patients and their parents.

Although it reduced distances between many functions, the design and construction team created a dual system of corridors: one for patients and families and the other for medical personnel and staff. By separating the two flows, it reduced bottlenecks and increased efficiency. It also created a nicer experience for children and families, since they don't see medical equipment and supplies being moved from one place to another. To help identify public walkways, the designers used color and artwork on the walls and ended them with glazing: windows where they reach the building's exterior and backlit colored panes at interior intersections. Staff corridors, on the other hand, are dressed in neutral color and whites.

Siting and daylighting played an important part in reducing energy use, says Brian Zeallear, a senior associate at NBBJ. By orienting the building to the south and shading this glazed facade with metal-mesh panels, the architects were able to bring daylight into a public corridor running the length of the building's second floor while protecting it from too much sun. Highly efficient mechanical and lighting systems plus green roofs cost an extra $560,000, but helped earn the project a $500,000 rebate from the utility company, and save about $117,000 each year in energy costs. Although the client decided not to install photovoltaics on the roofs or geothermal wells in the ground, the building can be upgraded with these elements in the future, says Brian Uyesugi, an NBBJ senior associate.

A pair of covered outdoor spaces on the ground floor—one that serves as an extension of an indoor cafe and the other that acts as a more contemplative area—bring daylight inside and help connect patients with nature. Such spaces reduce seasonal affective disorder (SAD) and contribute to a wellness-focused facility, says Holmes.

During construction, the building team organized the process so excavated earth was used for landscaping instead of being carted off-site. Nearly 95 percent of all construction materials were recycled and 25 percent were extracted or manufactured locally, reports Wright. Even some gypsum was used in the precast concrete panels cladding much of the building. Landscaping contributes to the project's green performance, with water runoff from paved areas and a partially underground parking structure flowing to a bioswale on the south part of the site, then to a retention pond on the east.

Doing more with less, SCBC shows how health care facilities can join the green movement and deliver a more pleasant experience to both customers and staff.


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